A cerebral palsy is a group of disorders that affect movement and muscle tone or posture. It's caused by damage that occurs to the immature brain as it develops, most often before birth. It refers to a brain injury or disorders that affect a person's ability to move thus making the brain non-progressive. It is a condition that results from injuries or abnormalities of the brain, mostly in the mother’s womb or occurs at any time during 2 years after birth.
People with cerebral palsy can have problems swallowing and commonly have an eye muscle imbalance, in which the eyes don’t focus on the same object. They also might have a reduced range of motion at various joints of their bodies due to muscle stiffness. Cerebral palsy’s effect on function varies greatly.
Types of Cerebral Palsy:
Cerebral palsy is broken down into different types to help describe how one’s brain damage has impacted their overall mobility. Each type of cerebral palsy is categorized using two factors: the type of movement issues and the body part(s) being affected.
Monoplegia: Only one limb’s movement is affected. It usually occurs in the arm or leg. This type of movement problem is very rare.
Diplegia: Two limbs, usually the legs, are affected. Oftentimes, those with diplegia have mild movement problems in the upper body as well. In those with cerebral palsy, diplegia is commonly the result of premature birth.
Hemiplegia: One side of the body is affected. The arm is usually more impacted than other limbs, distinguished by a rigidly flexed wrist or elbow. Some people with hemiplegia may not be able to use the affected hand. Prenatal bleeding in the brain can cause hemiplegia.
Triplegia: Three limbs are affected.
Quadriplegia: All four limbs are involved, but the legs are affected worse than the arms. There may be limited control over facial muscles as well.
Symptoms of Cerebral Palsy:
Signs and symptoms can vary greatly. Movement and coordination problems associated with cerebral palsy include:
1. Variations in muscle tone, such as being either too stiff or too floppy
2. Stiff muscles with normal reflexes (rigidity)
3. Stiff muscles and exaggerated reflexes (spasticity)
4. Tremors or involuntary movements
5. Slow, writhing movements
6. Excessive drooling or problems with swallowing
7. Delays in speech development or difficulty speaking
8. Difficulty with fine motor skills, such as buttoning clothes or picking up utensils
Causes of Cerebral Palsy:
Cerebral palsy is caused by damage to the developing brain before, during or after birth. There are multiple types of brain damage that can lead to different types of cerebral palsy. Cerebral palsy is caused by traumatic injury to a developing brain, including the parts of the brain responsible for motor control, coordination and balance. Damage to different parts of the brain’s motor control centers causes different types of cerebral palsy.
Infections during pregnancy – Mothers can pass infections to the fetus during pregnancy. Prenatal infections are most dangerous in the first few weeks after conception. German measles (rubella) and cytomegalovirus (CMV) during pregnancy are known causes of cerebral palsy.
Severe untreated jaundice – When a new-born has a yellow colour to their skin and/or eyes, it is known as jaundice. Jaundice is caused by excess bilirubin, a chemical pigment that is normally filtered out by the liver.
Brain injury during or shortly after birth – Blunt trauma to the infant or toddler brain can cause cerebral palsy. Head injuries may occur during labor or delivery or within the first several years of life.
Infections after birth – Infections (such as meningitis) contracted by new-borns can cause brain damage. Meningitis causes severe inflammation that can damage the motor control centers of the brain.
How Stem Cells Help in Cerebral Palsy :
The current Cerebral Palsy treatment is effective in managing symptoms but they do not repair the damage in brain. Therefore, researchers and scientists are now considering stem cell Cerebral Palsy treatment. However, now with advance research; we understand that it is possible to repair the damaged brain tissue using Stem cell Therapy. The autologous bone marrow derived mononuclear cells (BMMNCs) are used for transplantation. The transplanted stem cells work around the damaged tissue and affected areas helping in the repair of the damage in the brain.
Apart from stem cells, Children and adults with cerebral palsy treatment require long-term care with a medical care team. Besides a paediatrician or physiatrist and possibly a paediatric neurologist to oversee your child’s medical care, the team might include a variety of therapists and mental health specialists.
A variety of other therapies play an important role in treating cerebral palsy:
Physical therapy is typically the first, and most important, step toward in cerebral palsy treatment. It usually begins at a young age and is geared toward improving independent motor function. It is known to increase strength, mobility, posture, balance and flexibility of the joint.
Scoliosis (spinal curvature) and shortened Achilles tendons are some specific movement and posture issues that are treated with physical therapy. Physical therapy is an important prevention measure, as these issues can get worse over time.
Occupational therapy helps children with cerebral palsy improve fine motor skills. In general, physical therapy is used to improve gross motor function, but it doesn’t focus on fine motor function. Patients of cerebral palsy struggle with coordinating these skills for tasks such as grasping a spoon and bringing it to their mouth. But occupational therapists often work with physical and speech therapists to build a complete therapy plan.
Occupational therapists evaluate a child’s needs by testing his or her fine motor skills, perception and oral motor skills. By observing how the child responds to touch and movements, the therapist can determine a treatment plan.
Birth injuries can also affect the parts of the brain that control speech and the muscles that allow us to speak. Many children with CP have issues with speech due to their birth injury. Speech therapy can teach children how to pronounce certain words and communicate more effectively.
Speech therapists can diagnose speech issues and help improve language skills. They can also help with other skills, such as breathing and eating, because these issues involve the muscles in the mouth and face.
Medications can help manage both movement issues and secondary conditions that develop due to cerebral palsy. Conditions like seizures, involuntary movement, and spasticity are treated with Medications.
HBOT for Cerebral Palsy :
The theory underlying the use of hyperbaric oxygen therapy in cerebral palsy treatment is that there are cells within the damaged brain that are living but are not active and are not functioning as they should. The hope is that providing an increase in the supply of oxygen to these cells will switch them on again and start them functioning and so improves the child’s function.
Cost of Stem Cell Therapy with HBOT :
The patient must stay for 30 days, however in some cases 45 days of stay is recommended. The approximate cost of cerebral palsy treatment would range between USD 6500 to USD 10000 per cycle depending on current condition of the patient. Hyperbaric treatments average costs between 50-90 USD per session each of 60-90 minutes for 25-30 days daily.